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MRCP Part 1 > Opthalmology > Flashcards

Opthalmology Flashcards

1
Q

Causes of acute red eye

A 
Acute angle closure glaucoma
Anterior uveitis
Conjunctivitis
Scleritis
Epi-scleritis
Subconjunctivial haemorrhage
Endophalmitis
Keratitis
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2
Q

S+S acute angle closure glaucoma

A 
Severe pain (ocular or headache)
Decreased visual acuity
Patient sees halos
Semi dilated pupil 
Hazy cornea
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3
Q

S+S anterior uveitis

A 
Acute onset
Pain
Blurred vision
Photophobia
Small fixed oval pupil
Ciliary flush
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4
Q

S+S scleritis

A

Severe pain - worse on eye movements
Tenderness
May be underlying AI condition eg. RA

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5
Q

Most common causes of orbital/periorbital cellulitis

A

Streptococcus
Staph. aureus
Haemophillus influenzae B

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6
Q

Causes of sudden painless visual loss

A 
Ischaemic optic neuropathy
Central retinal vein occlusion
Central retinal artery occlusion
Vitreous haemorrhage
Retinal detachment
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7
Q

S+S ischaemic optic neuropathy

A

Altitudinal visual field defects

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8
Q

S+S central retinal vein occlusion

A

Sever retinal haemorrhages on fundoscopy

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9
Q

S+S vitreous haemorrhage

A

Large -> sudden visual loss
Medium -> several dark spots
Small -> floaters

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10
Q

S+S central arterial occlusion

A

Afferent pupillary defect

Cherry red spot on pale fundus

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11
Q

S+S retinal detachment

A

Curtain/veil over vison (from peripheral to central)
Straight lines become curved
Central visual loss

Often preceded by posterior vitreous detachment

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12
Q

S+S vitreous detachment

A

Flashes in peripheries

Floaters - commonly in temporal area

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13
Q

S+S keratitis

A

Red painful eye, photophobia, FB/gritty sensation, hypopynon

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14
Q

Causes of keratitis

A 
Bacterial -> S.aureus, P.aeriginosa (in contact lens wearers)
Viral -> herpes simplex
Fungal
Amoebic
Parasitic
Photo keratitis -> welding
Contact lenses
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15
Q

Causes of miosis

A 
Horners syndrome
Argyll-Roberston pupil
Senile miosis
Pontine haemorrhage
Congenital
Opiates
Parasympathomimetics -> pilocarpine
Organophosphate toxicity
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16
Q

Causes of mydriasis

A 
3rd nerve palsy
Holmes-Aide pupil
Traumatic iridoplegia
Pheochromocytoma
Congenital
Topical mydratics -> atropine
Sympathomemetics -> amphetamine, cocaine
Anti-cholinergics -> tricyclic anti-depressants
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17
Q

Causes of Argyll-Robertson pupil

A

Diabetes

Neurosyphillis

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18
Q

S+S Argyll-Robertson pupil

A

Small constricted pupil

Accomodation reflex present; pupillart reflex absent

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19
Q

S+S Holmes-Aide pupil

A 
Dilated pupil (usually unilateral)
Slowly reactive to accommodation but very poorly to light
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20
Q

Causes of Marcus-Gunn pupil

A

Retinal detachment

Optic neuritis

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21
Q

S+S Murcus-Gunn pupil

A

Affected eye dilated when light moved to it in swinging light test

22
Q

Fundoscopy features of papilloedema

A 
Venous engorgement
Loss of venous pulsation
Blurring of optic disc
Elevation of optic disc
Loss of optic cup
Paton's lines = Concentric/radial lines cascading from the optic disc
23
Q

Causes of pailloedema

A 
Space occupying lesion -> neoplastic/vascular
Malignant hypertension
Idiopathic intracranial hypertension
Hydrocephalus
Hypercapnia
Hypothyroid
Hypocalcaemia
Vitamin A toxicity
24
Q

Cause of tunnel vision

A 
Papilloedema
Glaucoma
Retinitis pigmentosa
Choroidoretinitis
Optic atrophy secondary to tabes dorsalis
Hysteria
25
What are angioid retinal streaks?
Irregular dark streaks radiating from the optic nerve head. | Due to degeneration, calcification and breaks in Bruchs membrane
26
Cause of angioid retinal streaks?
``` Pseudoxanthoma elasticum Ehler-Danls syndrome Pagets disease Sickle cell anaemia Acromegaly ```
27
What is optic atrophy?
Pale well demarcated disc on fundoscopy due to optic neuropathy. Usually bilateral. Associated with gradual loss of vision
28
Acquired causes of optic atrophy
MS Lonstanding papilloedema Increased intraocular pressure => glaucoma, tumours Retinal damage => choroiditis, retinitis pigmentosa Ischaemia Toxins => tobacco, methanol, arsenic, lead, quinine Nutritional => B1, B2, B6, B12
29
Congenital causes of optic atrophy
Freidrichs ataxia Mitochondrial => Lebers optic atrophy DIDMOAD
30
Congenital causes of optic atrophy
Freidrichs ataxia Mitochondrial => Lebers optic atrophy DIDMOAD
31
S+S optic neuritis
Unilateral decrease in visual acuity over hours to days Poor discrimination of colous => "red desaturation" Pain worse on eye movement Relative afferent pupillary defect Central scotoma
32
Causes of optic neuritis
MS Diabetes Syphillis
33
Ocular manifestations of RA
``` Keratoconjunctivitis siccs Episcleritis Scleritis Corneal ulceration Keratitis Steroid induced cataracts Chloroquine retinopathy ```
34
S+S retinitis pigmentosa
Night blindness Tunnel vision Fundoscopy = black bone spicule shaped pigmentation of peripheral retina & mottling of retinal pigmented epithelium
35
Conditions associated with retinitis pigmentosa
``` Usher syndrome Alports syndrome Kearns-Sayre syndrome Abetalipoprotein Lawrence-Moon-Beidl syndrome Refsums disease ```
36
S+S Horners syndrome
Miosis Anhidrosis Ptosis Enophthalmos
37
Site of lesion: Horners with anhidrosis of face, arm & trunk
Central lesion
38
Site of lesion: Horners with anhidrosis of face
Pre-ganglionic
39
Site of lesion: Horners with no anhidrosis
Post-ganglionic
40
Central cause of Horners
``` Stroke Syringomyelia Multiple sclerosis Tumour Encephalitis ```
41
Pre-Ganglionic cause of Horners
Pancoast tumour Trauma Thyroidectomy Cervical rib
42
Post-Ganglionic cause of Horners
Cavernous sinus thrombosis Carotid artery dissection Carotid aneurysm Cluster headache
43
S+S blepharitis
Usually bilateral Grittiness & discomfort Erythematous/swollen eyelid margins Styes and chalazions more common
44
Causes/RF for blepharitis
Meibomian gland dysfunction Seborrhoeic dermatitis Staphylococcal infection Rosacea
45
Treatment for blepharitis
BD hot compresses | Mechanical removal of debris
46
Causes of cataracts
``` Age related Steroids Smoking Excess alcohol Trauma Diabetes Radiation/heat exposure Metabolic disorders ```
47
Characteristics for dry ARMD
Drusen -> yellow spots within Bruch's membrane
48
Characteristics for wet ARMD
Neovascularisation Leakage of serous fluid Haemorrhages
49
Investigations for ARMD
Slit lamp Colour fundus photograph Flourescein angiography Ocular coherence tomography
50
Treatment for ARMD
Anti-oxidant vitamin A,C & E Anti-VEGF MAb Laser photocoagulation

MRCP Part 1 (13 decks)

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